Lengthy chatty phone calls, meeting new people, freshly brewed tea, making plans, hushed tones echoing through the library, making progress, job opportunities, feeling confident
Mental Illness
Happiness is
Bright bunches of flowers, unfurling petals, the rustle of leaves, raindrops on the window pane, dew-speckled grass, the early morning sun
CBT, OCD and Coming Clean
It’s been a good few weeks since I started CBT, and thought now would be the right time to share my experiences with you so far.
Since my mental health conditions are ongoing, I’ve had multiple assessments and this isn’t the first time I’ve had ‘talking therapy’ in order to help alleviate the symptoms of my anxiety and depression. When I initially presented with mental health problems, we decided counselling would be the best thing. Counselling is more about talking through the issues that are bothering you; CBT is working out how to change your behaviours and learning how to better rationalise your thoughts by searching for ‘evidence’, rather than clinging onto assumptions. Though I actually really benefited from counselling, it was the right thing for the time. I hadn’t explained my deepest, darkest fears before; I hadn’t confided in someone and told them all about my secrets and how I felt about myself and so on. And for that time, counselling was great. It gave me a voice, and provided that undivided attention I needed to address these issues and tackle my mental health head-on. Now I’m at a different stage in my life, and I didn’t feel talking about everything again would be beneficial right now.
This is where CBT comes in. The NHS defines CBT – or cognitive behavioural therapy – as ‘a talking therapy that can help you manage your problems by changing the way you think and behave’, and is particularly useful for ‘anxiety and depression, but can be useful for other mental and physical health problems,’ (NHS, 2014). Rather than just discussing your thoughts, emotions and resulting behaviours, you are actively developing coping strategies and methods to manage your behaviours, which are often unhelpful and perhaps increase feelings of anxiety/depression.
It’s quite a long-winded explanation, so I’ll try and illustrate with an example from my sessions:
Situation : Seeing deadline date in diary
creates
Thoughts and Images: of a bad mark, disappointing others, feeling unworthy and useless
These thoughts and images then produce
Emotions and Physical Sensations: ‘nervous tummy’, palpitations, impending sense of doom and anxiety.
as a result of these emotional and physical sensations, my behaviour changes:
Behaviours/What I did: withdraw, ruminate, ask for reassurance, plan rather than do, hide away from impending situation.
These behaviours then reinforce my Thoughts and images, and so the cycle perpetuates and continues. The idea here is to address the behaviour; it is very difficult to stop the thoughts, but I can stop behaving in an unnecessary and unhelpful way. So, rather than withdraw, perhaps I should focus on what I have done. Changing this focus involves taking into account my good marks, keeping an activity diary to show myself what I have achieved despite how I’m feeling. I know this sounds so simple, but I often get too blinded by my anxiety and depression that I forget what I have done. It helps me immensely to keep track of this.
If you’ve had dealings with anxiety, depression or similar conditions, you’ll know how troublesome assumptions can be. And when I’m at my worst, when the irrational thoughts pop into my mind, it’s so hard to get rid of them. My therapist is keen on getting me to realise that my assumptions – eg ‘people think I’m stupid – are just that; assumed, with no real evidence. Assumptions are largely negative, and don’t help anything, so I’m working on undoing that negative thought process and replacing it with something useful, instead.
Another thing we’ve identified during my sessions is the fact I have OCD -obsessive, compulsive disorder – and have been engaging in classic ‘OCD’ behaviours, including repeatedly checking. This was a bit of a revelation for me. Admittedly, I did wonder whether the checking I’ve been doing was normal, but I didn’t realise it was OCD. I tend to become fixated with checking various things, including checking locks on doors, both in my own place and when using bathrooms on campus, and sometimes this checking can go on for minutes. On a particularly bad day, I’ll go to check multiple times an hour, or wake up and check because I’m so anxious about whatever it is I’m checking. I also like to have certain items arranged in a certain way; the hangers on my clothes rails are often rearranged every night for fear of ‘ruined’ clothes. I am always worried about things breaking because I didn’t put them away properly, so jewellery is often checked and put back, and my alarms set, reset, checked, set, reset, checked…you get the idea. It’s strange. Thing is, I know these things aren’t actually useful, but at the time, checking things is the only way to rid myself of the anxiety. It’s complex, because the more you check, the more you find it difficult to not check. My therapist described these behaviours as coping strategies, as they help me to feel like I’ve regained control, even if it’s just momentarily. And even though I know my door locks as soon as you close it, it just isn’t enough. It’s like my irrational thoughts, and my unhelpful assumptions; I know it isn’t really helpful, but in that moment, and at that time, that’s all I can do to alleviate my worry.
Undoing these things will take time, and will have to be done step-by-step, but for now I’m feeling positive, and I’m hoping to get the most out of my sessions. I have another on Tuesday, and hopefully my progress will continue.
It feels good to be sharing my progress with you. This is a good way for me to see how far I’ve come, and hopefully I’ll be able to look back at these posts and feel proud. I haven’t always been upfront about things, particularly the OCD, and it’s time to just accept it and learn how to deal with it. Mostly I’m sorry that I hadn’t told Drew, or at least not enough. Hopefully I’ve rectified that.
It’s fairly stressful over this way, but as always, I’ll find a way.
Hope you’re doing well and look after yourself.
Heather x
ps: here is the link to the NHS page regarding CBT if it’s of any use:nhs.uk/Conditions/Cognitive-behavioural-therapy/Pages/Introduction.aspx
Happiness is
Guinea pig hiccups, working in the summer sun, passersby saying hello, sunglasses and lipstick, shorts and skirts and linen shirts, making plans, dandelion seeds floating away on the breeze
Happiness is
the sun shining on my face, the bright bluebells in the garden, the sun shining through the trees, the veins on a leaf, distant laughter, delicate daisy petals, cats when they stretch and lounge in the sun, cherry blossom confetti,the sizzle in the pan, the first sip of wine.
CBT and working through
Just thought I’d provide a quick update re: counselling etc. Ages ago (when I first presented with MH problems) I probably mentioned having to have an initial assessment to see what things would be most useful. This time around was no different, and almost the entire session comprised of filling out scales to determine levels of anxiety/depression.
I have a lot of difficulty with these scales as I find it so difficult to assign emotions a numerical figure, but they are aiming to assess the degree to which said mental health problems affect your life. I suppose it’s very difficult to assess anyway, and I know scales are one of the only feasible options, but they’re so difficult to navigate. Scales exist in a similar fashion for pain management, and that’s perhaps why I find them so frustrating. I’m always filling them out, and I don’t always understand what they mean/how useful they are.
After filling out these scales, we had a quick chat about my mental health history. These chats are often the most difficult part of assessments; they take you right back to a time you’d rather forget. I always find it difficult to control myself when I talk about things from the past. I know it’s useful to address, but it never gets easier. It’s hard to admit that at one time I had difficulty leaving my room to use the bathroom, never mind leaving the house at all. Though I can appreciate how far I’ve come, it’s never easy to admit that I’ve really, really struggled in the past.
It’s completely my own complex, and I’m aware of that. It just hurts everytime to even think about it.
By the end of the assessment we’d decided CBT would be the best route. I’ve tried counselling, and at the time I had counselling it was extremely useful because I felt I just needed to talk and uncover all my deepest fears. Now that’s done, I don’t feel like it would be of any use. I need to learn how to control these feelings and physical symptoms, and CBT is the best fit for that.
We briefly talked about cycles of thoughts and resulting behaviours, and CBT will hopefully provide the techniques needed to break the cycles and work through the feelings as and when they occur. Thoughts will probably always pop into my mind, and I will always probably feel anxious about some things, but CBT works towards getting that to a manageable level. Recognising the physiological symptoms of anxiety is the first step, and hopefully I’ll be able to work through something to make things easier on bad days.
My first ‘proper’ CBT session starts next week, and I’ll keep you updated on my progress.
I hope you’re enjoying your day so far. It’s gorgeously bright and sunny over here, and I’m waiting for my coffee to cool before taking the first sip.
Mornings like these bring a smile to my face.
Look after yourself,
Heather x
Mental health, mentors and meds
Hello! I hope you’re doing okay. I thought I’d give you a little mental health update, which will be really useful for me to refer back to.
Things are starting to feel a bit better this end, and I’m hoping I’ll see even more progress. I’m crying a lot less – which is a great start – and I’m not as anxious when things don’t quite go to plan. I’m trying to handle things more calmly and think things through rationally, and this has been almost impossible at times, so things are definitely becoming more manageable.
I thought I’d had a blip, and at my last doctor’s appointment we discussed possibly upping my meds, but I’m getting back on track and powering through. I recently started seeing a mentor at university to keep my on track of work. One of my problems is I have very little faith in my work and abilities, so having someone to check in with every week is extremely helpful. It’s great to talk to someone who is completely impartial and she’s really kind and supportive.
I’m also heading back for another lot of counselling next week. I haven’t had a course of counselling for about nine months now, and I used to find it really useful. To make things more enjoyable I made the day all about me; I’d head into town, get some lunch, and sit in the sunshine whilst I waited for my appointment. I’m looking at these new sessions in the same way: they’re for me, and I’m going to get the most out of them. I’m hoping for good things.
I think I’m struggling with accepting the uncertainty of what’s to come, and that’s perhaps why I’ve been having really anxious days. I really like to know where I’m headed, and where I’m going in life, and at the minute I’m in an odd place where I need to look forward, but concentrate on the present. I suppose I need to learn that things will happen, but they’ll happen at their own pace. I’m in the middle of degree applications, job hunting and exploring all my options, and it’s all a little bit scary. I’m worried about coping with pain/fatigue, but I’m so desperate to prove myself.
I know I’ll work something out, but it’s hard not to worry about these things.
I know this is a really rambling post, but I’ll keep you updated on my counselling. Wish me luck!
Hope you’re having a great evening,
Heather x
O
Ps hello from Smudge; she’s been keeping me company.
